title: Validating a screening tool for mental health and substance use risk in an Indigenous prison population.
abstract: OBJECTIVE
  The Indigenous Risk Impact Screen (IRIS) is a validated culturally appropriate and widely used tool in the community for assessing substance use and mental disorder. This research aimed to assess the utility of this tool in an Indigenous prison population.
  
  
  METHODS
  The study used data collected from a cross-sectional study of mental health among Indigenous inmates in Queensland custodial centres (n = 395, 84% male). Participants were administered a modified version of the IRIS and International Classification of Diseases-10 diagnoses of substance use, depressive and anxiety disorders obtained using the Composite International Diagnostic Interview (CIDI). The concurrent validity of the modified IRIS was assessed against those of the CIDI.
  
  
  RESULTS
  Three hundred and twelve people screened as high risk for a substance use disorder and 179 were high risk for mental problems. There were 73% of males and 88% of females diagnosed with a mental disorder. The IRIS was an effective screener for substance use disorders, with high sensitivity of 94% and low specificity of 33%. The screener was less effective in identifying depression (sensitivity 82%, specificity 59%) and anxiety (sensitivity 68%, specificity 60%).
  
  
  CONCLUSIONS
  The IRIS is the first culturally appropriate screening instrument to be validated for the risk of drug and alcohol and mental disorder among Indigenous adults in custody.
  
  
  CONCLUSIONS
  This study demonstrated that the IRIS is a valid tool for screening of alcohol and drug use risk among an incarcerated Indigenous population. The IRIS could offer an opportunity to improve the identification, treatment and health outcomes for incarcerated Indigenous adults.
authors.affiliation: School of Pharmacy, University of Queensland, Herston, Australia; QADREC, School of Population Health, University of Queensland, Herston, Australia.
authors.forename: Coralie
authors.initials: C
authors.lastname: Ober
authors.forename: Kaeleen
authors.initials: K
authors.lastname: Dingle
authors.forename: Alexandra
authors.initials: A
authors.lastname: Clavarino
authors.forename: Jake M
authors.initials: JM
authors.lastname: Najman
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
authors.forename: Edward B
authors.initials: EB
authors.lastname: Heffernan
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data*; D011793:Queensland / Q000453:epidemiology; D012680:Sensitivity and Specificity; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D055815:Young Adult
keywords: Indigenous; mental health; prisoner; psychometric evaluation; screening instrument